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Pediatric primary care

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https://www.readbyqxmd.com/read/28530775/a-surgical-approach-to-iatrogenic-vascular-injuries-in-pediatric-cases
#1
Yüksel Beşir, Orhan Gökalp, Börteçin Eygi, Banu Bahriye Lafcı, Gamze Gökalp, Levent Yılık, Hasan İner, Ali Gürbüz
BACKGROUND: Surgical intervention is mandatory in many children who present with vascular trauma or in complicated cases after medical interventions. In this study, surgical interventions applied after vascular injuries in children were analyzed. METHODS: Between January 2002 and December 2012, 17 patients (aged under 18) who were admitted to the emergency room with vascular injuries were retrospectively analyzed. The data was collected through hospital records...
May 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28529665/slipped-capital-femoral-epiphysis-a-spectrum-of-surgical-care-and-changes-over-time
#2
R T Loder
PURPOSE: To survey the spectrum of surgical care in children with slipped capital femoral epiphysis (SCFE). This information is valuable in counselling the patient about the future treatment course. METHODS: Data for this study were obtained from the Pediatric Hospital Information System (PHIS) between 2004 and 2015. For all patients with an ICD9 diagnosis of 732.2, gender, ethnicity, hospital, medical record number, date of birth/admission/discharge, type of admission, length of stay, disposition and treatment(s) rendered were collected...
April 2017: Journal of Children's Orthopaedics
https://www.readbyqxmd.com/read/28529195/rapid-web-based-platform-for-assessment-of-orthopedic-surgery-patient-care-milestones-a-2-year-validation
#3
Kenneth R Gundle, Dayne T Mickelson, Arien Cherones, Jason Black, Doug P Hanel
OBJECTIVE: To determine the validity, feasibility, and responsiveness of a new web-based platform for rapid milestone-based evaluations of orthopedic surgery residents. SETTING: Single academic medical center, including a trauma center and pediatrics tertiary hospital. PARTICIPANTS: Forty residents (PG1-5) in an orthopedic residency program and their faculty evaluators. METHODS: Residents and faculty were trained and supported in the use of a novel trainee-initiated web-based evaluation system...
May 18, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28525404/growth-hormone-treatment-for-growth-hormone-deficiency-and-idiopathic-short-stature-new-guidelines-shaped-by-the-presence-and-absence-of-evidence
#4
Adda Grimberg, David B Allen
PURPOSE OF REVIEW: The Pediatric Endocrine Society recently published new guidelines for the use of human growth hormone (hGH) and human insulin-like growth factor-I (hIGF-I) treatment for growth hormone deficiency, idiopathic short stature, and primary IGF-I deficiency in children and adolescents. This review places the new guidelines in historical contexts of the life cycle of hGH and the evolution of US health care, and highlights their future implications. RECENT FINDINGS: The new hGH guidelines, the first to be created by the Grading of Recommendations Assessment, Development and Evaluation approach, are more conservative than their predecessors...
May 18, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28514463/pediatric-psoriasis-comorbidity-screening-guidelines
#5
Emily Osier, Audrey S Wang, Megha M Tollefson, Kelly M Cordoro, Stephen R Daniels, Andrew Eichenfield, Joel M Gelfand, Alice B Gottlieb, Alexa B Kimball, Mark Lebwohl, Nehal N Mehta, Amy S Paller, Jeffrey B Schwimmer, Dennis M Styne, Abby S Van Voorhees, Wynnis L Tom, Lawrence F Eichenfield
Importance: Psoriasis is a complex inflammatory skin condition associated with serious medical comorbidities in adults, including obesity, hypertension, dyslipidemia, type 2 diabetes mellitus, psoriatic arthritis, nonalcoholic fatty liver disease, depression, anxiety, and decreased quality of life. Because psoriasis begins in childhood in almost one-third of patients, early identification of risk may be critical to minimizing effects on future health. Objective: To develop the first set of guidelines for comorbidity screening for patients with pediatric psoriasis based on current evidence...
May 17, 2017: JAMA Dermatology
https://www.readbyqxmd.com/read/28511844/pediatric-nurse-practitioners-in-the-emergency-department-implications-for-education-and-research
#6
Tasha R Rutledge, Lisa E Merritt
The use of pediatric nurse practitioners in emergency departments is common in the United States. Defining competencies that are specific to the wide span of urgent and emergent pediatric conditions, along with a recognized practice standard for education and method of certification for pediatric nurse practitioners practicing in emergency care, is needed. Pediatric emergency departments require a team of providers with a skill set that aligns with each patient's needs. The use of qualified pediatric nurse practitioners on these teams, both primary care and acute care certified, to provide care to these children is expanding, with implications for education and research...
May 13, 2017: Journal of Pediatric Health Care
https://www.readbyqxmd.com/read/28511684/access-to-pediatric-rheumatology-care-for-juvenile-idiopathic-arthritis-in-the-united-arab-emirates
#7
Khulood Khawaja, Mustafa Al-Maini
BACKGROUND: This study looks at access to care for Juvenile Idiopathic Arthritis through pediatric rheumatology in the UAE, as an example of multi-ethnic society. METHODS: Patients with a diagnosis of Juvenile idiopathic arthritis were identified through the hospital electronic medical records system from January 1st 2011 to December 31st 2014. All residents of the United Arab Emirates hold an Emirates identity card. We divided our patients into two groups: Emirati-Emirates, who are native Emirati children and hold the Emirati nationality, as stated on their Emirates identity card, and who therefore have full, comprehensive access to free medical care; and non-Emirati-Emirates, who represent other nationalities, as stated on their Emirates identity card...
May 16, 2017: Pediatric Rheumatology Online Journal
https://www.readbyqxmd.com/read/28509687/trust-in-the-medical-profession-among-adolescents-in-an-emergency-department
#8
Kelstan Lynch Ellis, Kimberly Randell, John Lantos, Melissa K Miller
OBJECTIVE: The aims of this study were to assess trust in the medical profession among adolescents in an urban pediatric emergency department (ED) and explore factors associated with trust. METHODS: We used a computerized survey to assess personal trust, perceived trust among family/friends, health care use, general and genital examination preferences, health behaviors, and demographics among youth aged 14 to 19 years. The primary outcome was the mean composite score of a validated 5-item scale...
May 15, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28507424/migraine-celiac-disease-and-intestinal-microbiota
#9
COMMENT
Hakim Rahmoune, Nada Boutrid
Investigators from four European tertiary care hospitals (in Paris, France; Milan, Udine and Perugia, Italy) performed a case-control study of children and adolescents aged 6 to 17 years diagnosed with primary headaches in the emergency department by a pediatric neurologist using the validated ICHD-3 criteria.
February 2017: Pediatric neurology briefs
https://www.readbyqxmd.com/read/28505614/pulmonary-involvement-in-adult-patients-with-inborn-errors-of-metabolism
#10
Christel Tran, Frederic Barbey, Romain Lazor, Luisa Bonafé
Inborn errors of metabolism (IEM) are rare individually, but taken together, they affect 1 in 1,000 people. Most of the disease becomes apparent at the pediatric age; however, with the identification of late-onset forms, and with improved survival, several of these conditions may be found in adults of all ages. While the lung is not typically a primary site of clinical disease in patients with IEM, in some of them it can be a significantly affected organ with associated severe respiratory complications. Lung involvement can be a late- onset feature of a complex multisystemic disease, but sometimes it can also be the only manifestation of underlying IEM...
May 16, 2017: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/28505079/melatonin-secretion-is-increased-in-children-with-severe-traumatic-brain-injury
#11
Lucia Marseglia, Gabriella D'Angelo, Sara Manti, Immacolata Rulli, Vincenzo Salvo, Giuseppe Buonocore, Russel J Reiter, Eloisa Gitto
BACKGROUND: Traumatic brain injury (TBI) is a leading cause of death and disability in children. Oxidative stress plays a significant role in brain damage and melatonin exhibits both direct and indirect antioxidant effects. The primary aim of the present study was to evaluate serum melatonin levels in children with severe TBI in comparison to critically ill children admitted to the Pediatric Intensive Care Unit for conditions other than TBI. METHODS: Twenty-four children were evaluated, equally divided into severe TBI and no-TBI...
May 13, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28502240/pediatric-primary-care-providers-use-of-behavioral-health-consultation
#12
Prerna G Arora, Elizabeth H Connors, Kelly Coble, Angela Blizzard, Larry Wissow, David Pruitt
This column describes a qualitative study in which 32 primary care providers (PCPs) reported barriers to and facilitators of using a behavioral health (BH) consultation program. Barriers included program incompatibility with organizational culture, limited exposure to the program, existing access to referral sources, and negative beliefs about BH consultation. Reported facilitators included having personal relationships with BH program staff, exposure to program information, and positive beliefs about BH consultation...
May 15, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/28501233/pediatric-integrative-medicine
#13
REVIEW
David K Becker
The practice of pediatrics from an integrative framework is based on physician-patient relationship, informed by evidence, and approaches the health of children and their families from a broad perspective. This article reviews the basic principles of integrative pediatrics and summarizes data and integrative approaches to common pediatric conditions seen in the primary care setting.
June 2017: Primary Care
https://www.readbyqxmd.com/read/28498184/viral-suppression-and-hiv-drug-resistance-at-6-months-among-women-in-malawi-s-option-b-program-results-from-the-pure-malawi-study
#14
Mina Hosseinipour, Julie A E Nelson, Clement Trapence, Sarah E Rutstein, Florence Kasende, Virginia Kayoyo, Blessings Kaunda-Khangamwa, Kara Compliment, Christopher Stanley, Fabian Cataldo, Monique van Lettow, Nora E Rosenberg, Hannock Tweya, Salem Gugsa, Veena Sampathkumar, Erik Schouten, Michael Eliya, Frank Chimbwandira, Levison Chiwaula, Atupele Kapito-Tembo, Sam Phiri
BACKGROUND: In 2011, Malawi launched Option B+, a program of universal antiretroviral therapy (ART) treatment for pregnant and lactating women to optimize maternal health and prevent pediatric HIV infection. For optimal outcomes, women need to achieve HIVRNA suppression. We report 6-month HIVRNA suppression and HIV drug resistance in the PURE study. METHODS: PURE study was a cluster-randomized controlled trial evaluating 3 strategies for promoting uptake and retention; arm 1: Standard of Care, arm 2: Facility Peer Support, and arm 3: Community Peer support...
June 1, 2017: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/28493451/the-effect-of-an-electronic-health-record-based-tool-on-abnormal-pediatric-blood-pressure-recognition
#15
Sarah A Twichell, Corinna J Rea, Patrice Melvin, Andrew J Capraro, Joshua C Mandel, Michael A Ferguson, Daniel J Nigrin, Kenneth D Mandl, Dionne Graham, Justin P Zachariah
BACKGROUND: Recognition of high blood pressure (BP) in children is poor, partly due to the need to compute age-sex-height referenced percentiles. This study examined the change in abnormal BP recognition before versus after the introduction of an electronic health record (EHR) app designed to calculate BP percentiles with a training lecture. METHODS AND RESULTS: Clinical data were extracted on all ambulatory, non-urgent encounters for children 3-18 years old seen in primary care, endocrinology, cardiology, or nephrology clinics at an urban, academic hospital in the year before and the year after app introduction...
May 11, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28492405/a-case-control-analysis-of-postoperative-fluid-balance-and-mortality-after-pediatric-cardiac-surgery
#16
Meth R Delpachitra, Siva P Namachivayam, Johnny Millar, Carmel Delzoppo, Warwick W Butt
OBJECTIVES: A positive fluid balance after cardiac surgery may be associated with poor outcomes; however, previous studies looking at this association have been limited by the number of deaths in the study population. Our primary aim was to determine the relationship between postoperative cumulative fluid balance and mortality in cardiac surgical patients. Secondary aims were to study the association between fluid balance and duration of mechanical ventilation, intensive care and hospital length of stay...
May 10, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28487930/the-effects-of-medication-alerts-on-prescriber-response-in-a-pediatric-hospital
#17
Judith W Dexheimer, Eric S Kirkendall, Michal Kouril, Philip A Hagedorn, Thomas Minich, Leo L Duan, Monifa Mahdi, Rhonda Szczesniak, S Andrew Spooner
OBJECTIVE: More than 70% of hospitals in the United States have electronic health records (EHRs). Clinical decision support (CDS) presents clinicians with electronic alerts during the course of patient care; however, alert fatigue can influence a provider's response to any EHR alert. The primary goal was to evaluate the effects of alert burden on user response to the alerts. METHODS: We performed a retrospective study of medication alerts over a 24-month period (1/2013-12/2014) in a large pediatric academic medical center...
May 10, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28486386/fluid-overload-and-cumulative-thoracostomy-output-are-associated-with-surgical-site-infection-after-pediatric-cardiothoracic-surgery
#18
Anthony A Sochet, Aoibhinn Nyhan, Michael C Spaeder, Alexander M Cartron, Xiaoyan Song, Darren Klugman, Anna T Brown
OBJECTIVES: To determine the impact of cumulative, postoperative thoracostomy output, amount of bolus IV fluids and peak fluid overload on the incidence and odds of developing a deep surgical site infection following pediatric cardiothoracic surgery. DESIGN: A single-center, nested, retrospective, matched case-control study. SETTING: A 26-bed cardiac ICU in a 303-bed tertiary care pediatric hospital. PATIENTS: Cases with deep surgical site infection following cardiothoracic surgery were identified retrospectively from January 2010 through December 2013 and individually matched to controls at a ratio of 1:2 by age, gender, Risk Adjustment for Congenital Heart Surgery score, Society of Thoracic Surgeons-European Association for Cardiothoracic Surgery category, primary cardiac diagnosis, and procedure...
May 8, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28486265/effect-of-family-presence-on-advanced-trauma-life-support-task-performance-during-pediatric-trauma-team-evaluation
#19
Karen J OʼConnell, Elizabeth A Carter, Jennifer L Fritzeen, Lauren J Waterhouse, Randall S Burd
IMPORTANCE: In many hospitals, family members are separated from their children during the early phases of trauma care. Including family members during this phase of trauma care varies by institution and is limited by concerns for adverse effects on clinical care. OBJECTIVE: The aim of this study is to evaluate the effect of family presence (FP) on advanced trauma life support primary and secondary survey task performance by pediatric trauma teams. We hypothesized that trauma care with FP would be noninferior to care when families were absent...
May 8, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28485351/pediatric-brain-tumors-an-analysis-of-5-years-of-data-from-a-tertiary-cancer-care-center-india
#20
R Madhavan, B P Kannabiran, A M Nithya, J Kani, P Balasubramaniam, S Shanmugakumar
BACKGROUND: Pediatric brain tumors are the most common solid tumors in children and a leading cause of mortality and morbidity in children worldwide. Even though there are enough data about the epidemiology of pediatric brain tumors in western population, there are only a few reports from developing countries like India. AIMS: To study the epidemiological patterns of brain tumors in children, to study the patterns of care, and to assess the treatment response. MATERIALS AND METHODS: A retrospective epidemiological approach is used...
October 2016: Indian Journal of Cancer
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